by EBSCO Medical Review Board
(Adrenal Insufficiency; Adrenocortical Hypofunction; Chronic Adrenocortical Insufficiency; Hypoadrenalism)


Addison disease happens when the adrenal glands do not make enough of a hormone called cortisol. It helps the body with things like blood pressure, metabolism, and the immune system. Levels of another hormone called aldosterone may also be low.

The disease may be:

  • Primary—the adrenal glands cannot make hormones
  • Secondary—other hormones that tell the adrenal glands what to do are missing or low

A severe problem from this disease is Addisonian or adrenal crisis. It can be deadly.

Adrenal Glands
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Primary Addison disease is caused by problems with the outer layer of the adrenal gland. This can happen slowly over time.

Addison disease is most often caused by the immune system attacking the gland. It is not known why this happens.

The gland may be harmed by infections, such as:

Less common causes are:

  • Some cancers
  • Amyloidosis—buildup of certain proteins in tissue
  • Bleeding in the glands—may happen because of blood thinning drugs or shock
  • Having the glands removed with surgery
  • Genetic problems or birth defects that make it hard for the glands to work the right way
  • Certain medicines

Secondary Addison disease can be caused by harm to the pituitary gland. This gland sends hormones that control the adrenal gland.

This disease may also happen when a person has taken corticosteroids for a long time and then stops.

Risk Factors

This disease is more common in women.

Other things that may raise the risk are:


A person with Addison disease may:

  • Be very tired
  • Not be hungry or lose weight
  • Have nausea and vomiting
  • Have muscle and joint pain
  • Have dark freckles on nipples, scars, skin creases, gums, mouth, and nail beds
  • Crave salty foods
  • Have mental health issues, such as depression
  • Women may have:
    • Dry and itchy skin
    • Lack of sex drive


The doctor will ask about your symptoms and health history. A physical exam will be done.

Blood and urine tests may be done to check hormone levels.

Pictures may be taken. This can be done with:


There is no cure. The goal is to manage symptoms and lower the risk of adrenal crisis.

Medicines can be given to replace missing hormones. The dose may need to be raised during times of stress or sickness, such as surgery, pregnancy, or trauma.


Addison disease cannot be prevented.


Family Doctor—American Academy of Family Physicians 

National Adrenal Diseases Foundation 


The Canadian Addison Society 

Health Canada 


Adrenal insufficiency and Addison's disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: Accessed April 28, 2022.

Adrenal insufficiency in adults. EBSCO DynaMed website. Available at: Accessed April 28, 2022.

Munir, S. Quintanilla Rodriguez, B.S., et al. Addison disease. StatPearls, 2021. Available at: Accessed April 28, 2022.

Revision Information

  • Reviewer: EBSCO Medical Review Board James P. Cornell, MD
  • Review Date: 02/2022
  • Update Date: 04/29/2022